Theory and Reality of Value-Based Purchasing: Lessons from the Pioneer
Table 1. Employer Purchasing Initiatives
| Whom Do They Target? | What Do They Want to Know? | Where Do They Get It? | How Do They Communicate It? |
|---|---|---|---|
| Health plans | |||
| General Motors, Digital, GTE, Pacific Business Group on Health, Gateway Purchasing Assoc., Chicago Business Group on Health | Patient satisfaction, incidence of early intervention, preventive care measures, health outcomes, accessibility of care | HEDIS 2.5-3.0, consulting firms, NCQA accreditation, site visits, satisfaction surveys (will use CAHPS® when available), FACCT | Report cards on plans (mainly satisfaction data), Internet |
| Health care systems | |||
| Buyer's Health Care Action Group(1) (Minneapolis-St. Paul), Community Health Purchasing Corporation (Central Iowa) | Patient satisfaction, health outcomes, willingness to provide quality data | Practice guidelines, FACCT, surveys | Profiles of care systems accessible to consumers at kiosks in workplace, commercial settings; Internet |
| Hospitals | |||
| Dallas-Ft. Worth Business Group on Health, Health Action Council of Northeastern Ohio (1), Health Care Cost Containment Council (PA)(1) | Conformance with best practices, clinical outcomes (risk-adjusted mortality rates, readmission rates, complication rates) | Critical pathways, JCAHO, system vendors (e.g., MediQual, Apache) | Report cards on hospitals in Cleveland, St. Louis, Tampa, etc.; planned in Dallas-Ft. Worth |
| Physicians | |||
| Dallas-Ft. Worth Business Group on Health, Pacific Business Group on Health, Pacific Bell | Patient satisfaction, conformance with protocols, guidelines; experience, training; incidence/resolution of malpractice claims; clinical outcomes | Physician value, check survey, TMQC accreditation, benchmarking, physician profiling reports from system vendors | Limited activity to date |
(1) Not profiled in this
study.
Note: HEDIS=Health Plan Employer Data and Information Set,
NCQA=National Committee for Quality Assurance, CAHPS®=Consumer Assessment of
Health Plans, FACCT=Foundation for Accountability, JCAHO=Joint Commission on
Accreditation of Healthcare Organizations, TMQC=The Medical Quality
Commission.
Page originally created September 2012
The information on this page is archived and provided for reference purposes only.


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